Friday, June 19, 2009

A World Without Words

Speech-Language Pathologists are in short supply here, so during the summer when I have more free time I sometimes pick up some per diem hours at a couple of nursing facilities. It helps me stay current with the medical model of speech therapy vs. the educational model I work in the rest of the year. I used to be the Rehab. Director at one of the facilities I now go into, so there is a sense of familiarity to it. It brings back memories to walk those halls.

This past week I was asked to do an evaluation on a woman who had had a stroke. Her right leg and arm were paralyzed, and when I went in her room to talk to her, I realized she had significant aphasia. She could produce the phrase, "I can understand...." then she would shrug her shoulders and point to her mouth. So I finished her sentence, "...but you can't get the words out." "Yeah," she would nod emphatically. She had another ready phrase, "This is here", which she used to try to explain everything from where her cousin lived to what she had for breakfast, and a couple swear words. That was pretty much the extent of her expressive vocabulary. What was tough with this one was the woman is younger than I am -- she had her stroke at the age of 50. So we engaged in a serious game of 20 questions as I learned more about her and her (limited) abilities.

Dinner time came and she sat in her wheelchair in her room, across from her elderly roommate who was dozing in her chair. I asked her if she would like to eat in the dining room -- a bright, sunny room, with a big screen TV set to some upbeat sitcoms. She smiled and said, "yeah!" So I checked in with the nurse, got the go ahead, and wheeled her down to the dining room. Apparently no one had thought to ask her where she would prefer to eat in the 3-4 days she had been there. The nurse had her tray delivered, and I made sure she had a ring side seat to watch TV while she ate.

As I got ready to leave a little later, she motioned me over. She grabbed my hand, and with tears in her eyes, she managed to say, "Thank you." It moved me tremendously, and I thought about that moment all the way home. Now I'm at a loss for words to express what I learned, wrapped up in that afternoon we spent communicating.

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